Summer - United States Special Operations Command

(2) Use drip-free gelpacks as a refrigerant. Pack refrigerantin a separate bag than the sample. Liquidmust not leak from the shippingcontainer during transit so DO NOTUSE wet ice to ship!(3) Labeling ShippingContainers and ShippingDocuments(a) Animal specimensfor rabies diagnosis areconsidered DIAGNOSTICspecimens. Special labeling isnot required for shipment of diagnosticspecimens. DO NOTlabel the exterior of the shippingcontainer as a “rabies specimen.”(b) Place the completedDD Form 2620 in asealed plastic bag and place iton top, between the inner andouter containers. Affix a copyof the request form, in an envelope,to the top of the outershipping container. Be sure toinclude a point of contact whocan receive the laboratory reportupon completion of testing.Phone numbers for that individual(day and night) must belisted.(c) The phrase“Diagnostic Specimen – Animal”should be used on alltransportation documents(GBL, Airbill, etc.) to describethe specimen shipped. DONOT mention “rabies.”c. Method of Shipment: Ship bythe most expeditious means (overnight,next day delivery) available. If shippingon a Friday, the shipper must be specificallytold that the item needs to be delivered(the following day) on aSaturday and the laboratory notified sothat they can have an employee availableto receive on a Saturday.d. Notify the laboratory by telephoneas soon as the specimenhas been shipped and providethe following:(1) Type of animal.(2) Indicate whether or nothuman exposure was involved.(3) Specify the method ofshipment used and the sample’s estimatedtime of arrival to the lab.NOTE: Notification is vitally important,especially when a rabies suspect sampleis shipped for Saturday or holiday delivery.The laboratory is normally notstaffed on weekends/holidays and specialarrangements must be made to receiveand process the specimen.One of the capabilities that the MDVS now havein Iraq and Afghanistan is a rabies screening test that canbe conducted at the VTF. The direct rapid immunohistochemistrytest (DRIT) was developed at the Centers forDisease Control and Prevention (CDC) as an environmentalsurveillance, screening, and data gathering tool.Army veterinary pathologist LTC Greg Saturday fromVLE was trained by the CDC to conduct the test, and hehas traveled to Iraq and Afghanistan training the MDVSto run the DRIT test in their VTFs. The DRIT test is aten-step process that can be completed in about an hour.Impression smears of the obex of the brain stem are madeand fixed in formalin, and are then held until there areenough to batch test – usually ten samples plus a negativeand positive control. At the end of the hour long process,the samples are viewed under a microscope to look forred inclusions in the sample. The presence of red inclusionsindicates a rabies positive sample. Any DRIT positivesample tissue must be sent to VLE for aconfirmatory direct fluorescent antibody (DFA) test.Studies have shown that the DRIT has specificity andsensitivity equivalent to the DFA.POINTS OF CONTACTWorldwide:DOD Veterinary Food Analysis and Diagnostic Laboratory(FADL)Attn: MCVS-Lab2472 Schofield Rd Suite 2630Fort Sam Houston, TX 78234-6232Capabilities: Full chemical, microbiological and diagnosticDeputy Director: MAJ Alisa Wilma, 210-295-4322,Alisa.WilmaMAJAMEDDCS@amedd.army.milRabies POCs: Edwin Cooper, 210-295-4920,Edwin.cooper@amedd.army.mil; Michael Gray, 210-295-4736, Micheal.gray@amedd.army.milDSN: 421-4604/4761Comm: 210-295-4604/4761Sample receiving area: 210-295-4210FAX: 210-270-2559102Journal of Special Operations Medicine Volume 9, Edition 3 / Summer 09